Abstract
The perception of pain involves the activation of the spinal pathway as well as the supra-spinal pathway, which targets brain regions involved in affective and cognitive processes. Pain and emotions have the capacity to influence each other reciprocally; negative emotions, such as depression and anxiety, increase the risk for chronic pain, which may lead to anxiety and depression. The amygdala is a key-player in the expression of emotions, receives direct nociceptive information from the parabrachial nucleus, and is densely innervated by noradrenergic brain centers. In recent years, the amygdala has attracted increasing interest for its role in pain perception and modulation. In this review, we will give a short overview of structures involved in the pain pathway, zoom in to afferent and efferent connections to and from the amygdala, with emphasis on the direct parabrachio-amygdaloid pathway and discuss the evidence for amygdala's role in pain processing and modulation. In addition to the involvement of the amygdala in negative emotions during the perception of pain, this brain structure is also a target site for many neuromodulators to regulate the perception of pain. We will end this article with a short review on the effects of noradrenaline and its role in hypoalgesia and analgesia.
Highlights
Pain is a conscious and subjective experience that is evoked in response to a stimulus that causes, or has the potential to cause harm
Individuals suffering from chronic pain, such as musculoskeletal pain and daily headaches often suffer from depression and show attention deficits [5]
The amygdala seems to be involved in stress-induced analgesia, which is in part modulated by noradrenaline
Summary
The detection of mechanical, chemical and thermal noxious stimuli occurs through the stimulation of pain receptors (nociceptors), located at the terminals of Aδ and C fibers. The parabrachial nucleus in particular receives some of the largest projections from the dorsal horn and in turn projects to PAG, hypothalamus, amygdala as well as back to the dorsal horn, potentially playing an important role in both the autonomic and emotional responses to pain [21] and have been found to be involved in the descending inhibition of nociception via the reciprocal connections to the dorsal horn [8,29].
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